Why should healthcare be 'free'?

kabayiri

antrobus wrote: »

Which would be counter-productive if you wanted to cut overall healthcare costs.

Chip eating smokers who spend their free time sitting on the sofa stuffing their faces with crisps washed down with supermarket lager will drop dead from a heart attack at 57 and cost the NHS very little. It's the healthy-diet-and-regular-exercise mob that you have to worry about; they're the ones that will coast to 97 and cost the NHS a fortune.

Your argument suggests we all smoke 60 a day, and drink like an English person permanently on holiday; in a bid to keep NHS costs down!

Which would not work. The NHS would simply devote more resources to gastric bands, liver transplants, and lung cancer treatment, in an effort to keep us alive, possibly at vast cost. That is it's primary purpose I believe, keeping the population alive and healthy.

We need more healthy individuals who are cost neutral as a minimum to the NHS, to counter the minority cases which consume disproportionately more from the system.

chewmylegoff

adouglasmhor wrote: »

You do understand what the words part, assurance and insurance mean don't you?

I understand what the dictionary definition of each word is, but also the substance of the situation which is that NI is simply a limb of general taxation which does not, in reality, pay for anything specific or convey anything in particular onto he payee.

You can test this out if you like by not working ever, and never paying any NI. The NHS will still fix you, the govt will still pay you benefits, and when you get old enough, the minimum income guarantee will still kick in. The idea that NI is anything other than a general income tax is frankly preposterous.

adouglasmhor

chewmylegoff wrote: »

I understand what the dictionary definition of each word is, but also the substance of the situation which is that NI is simply a limb of general taxation which does not, in reality, pay for anything specific or convey anything in particular onto he payee.

You can test this out if you like by not working ever, and never paying any NI. The NHS will still fix you, the govt will still pay you benefits, and when you get old enough, the minimum income guarantee will still kick in. The idea that NI is anything other than a general income tax is frankly preposterous.

I don't think the poster you relied to was seriously suggesting that the income for NI was soley used to fund welfare etc., and I think you are being disingenuous for suggesting otherwise. But he was right in suggesting that NI was part of an agreement or covenant of a kind between the public and the state.

Generali

adouglasmhor wrote: »

I don't think the poster you relied to was seriously suggesting that the income for NI was soley used to fund welfare etc., and I think you are being disingenuous for suggesting otherwise. But he was right in suggesting that NI was part of an agreement or covenant of a kind between the public and the state.

NI is symbolic of a covenant but is just another part of the BBB setup of the NHS.

I think it would be a splendid idea for the welfare state to be entirely funded by National Insurance. It would concentrate the mind of voters if they were confronted with the precise cost of the Governments' largesse.

adouglasmhor

Generali wrote: »

NI is symbolic of a covenant but is just another part of the BBB setup of the NHS.

I think it would be a splendid idea for the welfare state to be entirely funded by National Insurance. It would concentrate the mind of voters if they were confronted with the precise cost of the Governments' largesse.

I could not agree more, and symbolic was exactly the word I could not remember, thanks.

N1AK

Generali wrote: »

I've been on the planet for about 15,000 days and have needed to drink water on pretty much all of those days, eat food at least a couple of times a week, have shelter and warmth and yet it is considered normal for me to pay for those things which keep me alive.

Surely if there is an argument for anything being free at the point of use it should be these greater essentials. So why pick out healthcare? I don't get it.

The government provides benefits which are sufficient to provide food, water, shelter, heating etc for those with incomes insufficient to afford them. The equivalent would be forcing people to buy health insurance if they could afford it and the government paying for it for those who can't.

However as that doesn't appear to be what you are suggesting the reasons for universal healthcare are:

• Decreased administrative cost (no need to check your covered).
• Discourage people leaving problems to get worse, requiring more extensive & expensive care
• Basic human compassion

Not having universal healthcare leads to issues on a number of levels.

Compassion
Do we turn away a child who has been fatally injured because their parents didn't buy insurance? Do we allow a pensioner to slowly die of internal bleeding after a fall?

Societal benefits
(Good) healthcare helps keep people fit and healthy. This keeps them working, it avoids other support issues in later life etc.

Personally one of the few things I liked about Michael Howard's policies when he ran was the idea that you could take half the value of NHS treatment and use it for private treatment if you wished. The British public being a success-hating lot they decided they'd rather cut off their nose and pay more than allow more people to access private healthcare.

If they'd pulled the policy off then my partner and I would both have private insurance by now (cutting our treatment cost to the NHS by half) while making it more affordable.

chewmylegoff

adouglasmhor wrote: »

I don't think the poster you relied to was seriously suggesting that the income for NI was soley used to fund welfare etc., and I think you are being disingenuous for suggesting otherwise. But he was right in suggesting that NI was part of an agreement or covenant of a kind between the public and the state.

i may have misinterpreted what he meant, he may clarify that in due course. if i did, it was not deliberate - and what would be the point, i wouldn't need to twist what he said in order to make the point i was making. which is that i don't think there is any validity in claiming that NI is, in reality, any kind of insurance at all, or indeed indicative of any "contract" between the state and the public.

if it does then why (a) does the greater contribution of general taxation towards the relevant costs not create such a contract (b) can the government unilaterally change the terms on which it provides the things supposedly covered by the contract and (c) don't you need to actually pay the NI or any taxation to access the benefits.

NI is just another piece of general taxation, and the only reason it has remained separate is that it gives the government another convenient lever with which to adjust taxation on businesses which avoiding messing with the "headline" rates of income tax and corporation tax which people pay more attention to.

all it symbolises is government manipulation of our thinking.

adouglasmhor

Some benefits are still contribution based.

Arg

chewmylegoff wrote: »

You can test this out if you like by not working ever, and never paying any NI. The NHS will still fix you, the govt will still pay you benefits, and when you get old enough, the minimum income guarantee will still kick in. The idea that NI is anything other than a general income tax is frankly preposterous.

The idea that the NHS will fix you is equally preposterous. The government also try and cheat you out of benefits. A lot of private medicine is just as bad but at least you can order it there and then instead of an NHS GP trying to fob you off until something becomes more serious.

rtho782

I would want the following....

Drug Patents to be unenforceable with regards to government agencies, so the NHS can comission off brand equivalents of patented drugs saving costs.

Non-essential operations, e.g. cosmetic surgury, gastric bands, gender reassignment, etc should not be availible on the NHS.

Abolish free prescriptions, fixed price of £10 for anything from a GP appointment to a prescription. A+E visits would still be free, you'd expect them to tell you to go away if you were not ill!

This would discourage the old grannys that visit their GP just for a chat and the hypochondriacs that research a sniffle online and diagnose cancer or lupus from bothering their GP every 5 mins, but still not mean that you can't afford to visit the GP.

As for the "smokers/obese people should pay more" argument, I don't really agree. Each person is going to cost to look after at their end of life, no matter if that is from lung cancer at 40 due to smoking, cardiac arrest at 35 due to cholesterol, or round the clock care due to dementia at 100 because they haven't killed themselves smoking/eating.

At least the smoker and obese person didn't live long enough to claim a state pension as well!